[Morphological changes in femoral vein wall structure in presence of persistent vertical reflux]

The article contains an analysis of different mechanisms of persistent chronic venous insufficiency formation and its impact on the condition of lower extremity magistral vein wall. The authors studied autopsy samples of femoral vein segments from 86 patients aged 56 to 64 years, who had died of non-cardiovascular diseases. The investigation revealed significant changes in the vein wall structure, associated with persistent overload caused by valvular insufficiency and continuous persistent vertical reflux. At the same time, valve cusp structure remodels. Histological studies show that the overload of the system of deep femoral vein segment primarily increases the bulk of longitudinal smooth muscle cells, which fulfill the main contractile function in contrast to circular smooth muscle cells, performing the tonic function. Further overload of all vein wall structures results in structural alterations, smooth muscle cell hypertrophy, forming of longitudinal smooth muscle cell fascicle, and finally, their dystrophic changes. These processes bring about clinical presentations of chronic venous insufficiency.